While obesity prevention efforts at schools have focused on multi-faceted interventions
combining changes to the lunchroom, integrated nutrition education programs, improvements
to the school lunch and increased parent involvement, evaluating the impacts of these
programs can be difficult. Sponsors of policy changes which have driven these efforts seek
evidence that they have made a positive impact on student behavior and ultimately, student health.
However, the current dearth of validated methods of assessing dietary intake in children
has made program evaluation difficult.

More than forty attendees involved in school-based nutrition
interventions gathered at the University of Washington on March 7, 2006
to hear national experts speak at the ECOR-sponsored workshop School-Based Nutrition Interventions: Measuring Dietary
Intake of Children. This dynamic workshop provided attendees
with an opportunity to interact with speakers
and to develop a systematic framework for
aligning their own program intervention goals
with appropriate and feasible evaluation methods.

Important take-home messages from the speakers included:

Alanna Moshfegh, MS RD: Diet and Eating Patterns of Kids Aged 9-12

Meal patterns of kids are changing. They eat breakfast and dinner less often than before and snack more.

The increased consumption of carbonated soft drinks, and the reduced consumption of milk during snacks is one particularly troubling trend.

Tom Baranowski, PhD: Methods for Dietary Intake Assessment in Kids

Every measure available for assessing dietary intake has error. It is important to know how much and what type of error is acceptable.

A successful evaluation requires a clear question. What do we want to ask, and what can we ask?

Carolyn Kramer, MPH: Realities of Working with Schools

When working with schools, be sure to understand the required evaluation guidelines, and invite all players to the table. Be patient, persistent and positive and work with people who are already committed and sympathetic to your concepts and ideas.

Developing evidence for public health programs is more difficult than developing evidence-baed clinical guidelines. Public health research tends to rely on observational studies, and the volume of evidence in generally smaller. Usually the time from the intervention to the desired outcome is long, making research difficult and costly.

While a randomized controlled trial is the "gold standard" in research; three well-done observational studies could also be considered robust. However, it is always necessary to have a comparison or control group.